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Cardiac Injury Predicts Mortality in COVID-19 Patients

A new study shows that mortality among COVID-19 patients with cardiac injury is more than ten times higher than is those without cardiac injury.

Researchers at Renmin Hospital (Wuhan, China) and Wuhan University (China) conducted a cohort study of 416 consecutive patients (median age 64 years, 50.7% female) with confirmed COVID-19 between January 20, 2020 and February 10, 2020. Clinical, laboratory, radiological, and treatment data were collected and analyzed, and the outcomes of patients with and without cardiac injury were compared in order to analyze association with mortality. Fever was the most common clinical symptom (80.3%), followed by cough (34.6%) and shortness of breath (28.1%).

The results showed that patients with cardiac injury had higher mortality (51.2%) than those without cardiac injury (4.5%). The 82 patients (19.7%) found to have cardiac injury were older (median 74 years of age) and had more comorbidities, such as hypertension and coronary heart disease (CAD). In addition, 22% of the patients with cardiac injury required mechanical ventilation, compared to just 4.2% in those without cardiac injury. The incidence of acute respiratory distress syndrome (ARDS) was 58.5% and 14.7%, respectively. The study was published on March 25, 2020, in JAMA Cardiology.

“Cardiac injury is a common condition among hospitalized patients with COVID-19 in Wuhan, China, and it is associated with higher risk of in-hospital mortality,” concluded lead author Shaobo Shi, MD, of Renmin Hospital, and colleagues. “On the basis of the present results, we can only estimate the severity of cardiac injury. Thus, because of the current limited evidence, the question of whether the SABRS-CoV-2 virus can directly injure the heart requires further demonstration.”

Since December 2019, COVID-19 has resulted in considerable morbidity and mortality worldwide. Severe respiratory distress is considered the main cause of coronavirus-induced death, and severe pneumonia is independently associated with admission to an intensive care unit (ICU), mechanical ventilation, or death. Emerging studies show that patients with cardiac injury present with more severe acute illness, manifested by abnormal laboratory and radiographic findings, such as higher levels of CRP, NT-proBNP, and creatinine levels; and more multiple mottling and ground-glass opacity on CT.